الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
BPH is one of the major causes of disturbance of male productivity in the last few decades, and the incidence increases with age as well as the socioeconomic standards of the society.[115] Many medications were foreseen in an attempt to get the best results in treating LUTS due to BPH with the least side effects, however the newest drugs gave promising results as Silodosin gave promising statistical and analytical results in our attempt in treating BPH .[92, 94]
Silodosin is a new selective therapy with a high pharmacologic selectivity for the a1A-AR,the next generation after Tamsulosin molecules and more effective than Doxazosin.[116]We conducted a prospective, randomized, placebo- and active-controlled parallel group study. A total of 100 men >50 year of age were divided equally into two groups, group-A received Tamsulosin 0.4mg once daily for 2 weeks, after completing 14-days ‘washout’ , Silodosin 8 mg once daily was introduced for 2 weeks. The same was done in group-B; apart from we started with Doxazosin XL 4mg once daily in the first two weeks.
We found that there is a change from the baseline data in the IPSS total score with Silodosin that was significantly superior to that with placebo, tamsulosin and doxazosin (p< 0.001). An increase in Qmax was observed in all groups. The adjusted mean change from baseline to end point was 4.24 ml/s for silodosin, 2.70 ml/s for doxazosin, 2.40 ml/s for tamsulosin and 2.40 ml/s for placebo, but the change for silodosin was statistically significant versus doxazosin, tamsulosin and placebo (p < 0.001).
Also silodosin has statistical significance versus doxazosin and tamsulosin regarding IPSS, QoL, P-QoL (p value <0.001) and PVR (p value 0.01and 0.04 respectively). The most frequent adverse event with silodosin was a reduced or absent ejaculation during orgasm (42%), a reversible effect as a consequence of the potent and selective a1A-adrenoreceptor antagonism of the drug. The incidence was higher than that observed with tamsulosin (24%) or doxazosin (10%); however, none of silodosin-treated patients discontinued treatment due to this adverse event. Hypotension was observed in (8%) in group B and only one patient in group A.